The long-term goal of this study is to develop and evaluate a multicultural, multilingual health literacy intervention to promote knowledge about the HPV vaccine and foster informed HPV immunization decisions among parents of preadolescent girls and among adolescent girls at high risk for HPV infection. The populations of interest in this study are Koreans, Vietnamese, Filipinos, African Americans and Latinos. The specific aims of this study are to: (1) identify HPV vaccine literacy levels, attitudes, perceptions and information sources among diverse at-risk populations, (2) identify specific themes, message elements and communication strategies for an intervention that enhances patient comprehension and evaluation of the risks and benefits of the vaccine, (3) identify cultural values, beliefs, and practices that influence attention, comprehension, and appraisal of HPV vaccine information intended to inform an immunization decision, (4) design and produce a multicultural, multilingual education intervention that delivers cognitively accessible, culturally competent, health literacy information about HPV vaccination tailored to diverse populations at high risk for HPV infection, and (5) evaluate the efficacy of an interactive multicultural, multilingual learning and decision tol using next-generation digital videodisc technology to increase patients' knowledge about the HPV vaccine, assess the risks and benefits attendant to HPV vaccination, and promote informed vaccination decisions among the diverse racial/ethnic groups in this study. This study responds to the HHS Initiative to Eliminate Racial and Ethnic Health Disparities, which cals atention to the gaps in access to preventive health resources, principally among racial and ethnic minorities. This study will conduct focus groups and cognitive interviews to guide development of culturally competent, age-appropriate materials tailored to 16 diverse audiences in four different languages (English, Spanish, Korean and Vietnamese) on a single Blu-ray disc. It will conduct cross-cultural validation of decision-making scales for use with our five study populations. It will also conduct a randomized, controlled efficacy evaluation of the health literacy intervention among the five study populations. The study enlists the collaboration of established, well-regarded community-based organizations from each of the racial/ethnic communities to guide the study and provide access to prospective study participants in their respective communities. It also leverages our extensive experience with complex, multicultural, multilingual studies to effectively manage the challenges of this multi-audience health literacy study. PUBLIC HEALTH RELEVANCE: This health literacy study addresses the need for multilingual, multicultural, HPV vaccine education materials to empower individuals at high risk for HPV infection to make an informed immunization decision, which offers a significant public health benefit.